Study Of Cine-MR1 For The Soft Tissue Of Oropharynx In Patients With Obstructive Sleep Apnea Hypopnea Syndrome During Sleep

Part 1 Study of Cine-MRl for the Morphology of Soft Palate in Patients with OSAHS During SleepObjective To investigate the morphological changes of soft palate in patients with OSAHS during nature sleep and assess the correlation with the severity of the disease.Methods21 male patients with preoperative polysomnography(PSG)diagnosed as 0SAHS were followed by Cine-MRI during wakefulness and natural sleep.Parameters of soft palate morphology were measured and compared in these twostates.The data analysis was carried out to find out significant correlations with the severity of the disease.Results During natural sleep,the length of soft palate and the included angle of hard and soft palate were increased than those during waking state(t=0.048;t=0.001?P< 0.05),the parameters of soft palate morphology were significantly correlated with apnea hypopnea index(AHI)(r=0.678;r=0.621;r=0.620?P<0.01)and TS90(r=0.747;r=0.649;r=0.664?P<0.01),and correlated with the lowest oxygen saturation(LSa O2)(r=-0.507;r=-0.478;r=-0.503?P<0.05).During wakefulness,Parameters of soft palate morphology were correlated with AHI,TS90 and LSa O2(P<0.05).Conclusion Cine MRI during natural sleep can reflect the morphological changes of the soft palate and be used in evaluating the severity of OSAHS in some ways,locating the obstruction sites and choosing the best treatment planing.Part 2 Study of Cine-MRl for the tongue in Patients with OSAHS During SleepObjective Using cine magnetic resonance(CMR)to analyze the size of the tongue during wakefulness and natural sleep in patients with OSAHS,and to compare the changes in tongue size in OSAHS patients with different severity.Methods 31 male patients diagnosed as 0SAHS by preoperative polysomnography(PSG)underwent CMR in awake and natural sleep state.The maximum and minimum values of the upper meridians,the lower meridians,and the vertical height on the sagittal plane of the tongue were measured.The difference was compared between the two tongue sizes.Then 31 patients were divided into mild/moderate group of 12 cases and severe group of 19 cases to compare the difference in tongue size between awake and natural sleep.Results Compared with the awake state,the maximum value of the upper and lower meridian and vertical height of the tongue under the natural sleep state,the difference between the maximum value and the minimum value was larger(P<0.05).Minimum values reflected tongue size and degree of change were all smaller than those in the awake state(P<0.05).There is no significant difference(P>0.05)in indicators of the tongue-size and the degree of change in the mild/moderate and severe OSAHS patients.Under the sleep state,the maximum value of the upper and lower meridian values,the difference between the maximum value and the minimum value,and the difference between the maximum and minimum value of the vertical height in the sagittal plane of the tongue of the severe OSAHS patients were larger than those in the mild-moderate group(P<0.05).Conclusions The size of the tongue and its degree of change in OSAHS patients are very diverse in awake and natural sleep state.That may be linked to the loss of neuromuscular compensation mechanism during sleep.The size of the tongue and the degree of change during sleep in severe OSAHS patients are greater than the mild-moderate OSAHS patients.